Very Hot Tea or Coffee and Esophageal Cancer Risk: What the New Oxford Study Found

A study of nearly 1 million UK adults, published in the International Journal of Cancer. It found that people who prefer very hot tea or coffee have roughly three times the risk of one esophageal cancer type compared with those who drink it warm. Keren Papier, a senior nutritional epidemiologist at Oxford Population Health, led the research with colleagues Kezia Gaitskell, Sarah Floud, and Gillian K. Reeves.

What the study actually found

The researchers combined data from two long-running UK studies: the Million Women Study (510,112 people, tracked for 14.2 years on average) and UK Biobank (467,170 people, tracked for 11.1 years on average). That's 977,282 people total. People reported if they liked their tea and coffee "warm," "hot," or "very hot" and how many cups they drank daily. Over follow-up, there were 2,348 esophageal cancers: 1,045 squamous cell carcinomas (SCC) and 1,303 adenocarcinomas (AC).

People who preferred very hot drinks had about 3.2 times the risk of esophageal SCC compared with those who liked them warm. This held even after accounting for how many drinks they had daily. Those who preferred hot (but not very hot) drinks had about 1.7 times the risk. Drinking six or more hot drinks daily, regardless of temperature, was linked to a 71% higher SCC risk compared with fewer. About 14% of SCC cases—roughly 440 per year in the UK—could be prevented if people who like very hot drinks cooled them to hot instead.

But this did not apply to esophageal adenocarcinoma, the other main esophageal cancer type. That's more linked to chronic acid reflux and obesity. Drink temperature and how often you drink didn't affect AC risk. The findings held up whether people drank mostly tea or mostly coffee, and whether or not they added milk.

Why this is plausible, and where the evidence is limited

The WHO's cancer arm (IARC) classified very hot beverages above about 65°C as "probably carcinogenic" in 2016. This was based on earlier studies from Iran, South America, and Asia where scalding tea or mate is common. What was less clear: does this apply to the cooler temperatures—around 60°C—common for US and UK tea and coffee? This is the largest study yet to test this in a Western population. The authors argue the pattern points to a "thermal injury" mechanism: repeated heat damage to the esophagus lining, not something in the tea or coffee itself.

But this is an observational study, not an experiment. "Warm," "hot," and "very hot" were self-reported, not measured. So they weren't verified. The authors also note they can't rule out other differences between people who like very hot drinks and those who don't. They adjusted for smoking, alcohol, and deprivation, but other factors might exist. The link held even when they removed the first five years of data. This argues against early, undiagnosed cancer explaining the results.

Signs and symptoms to know

Esophageal cancer usually causes few early symptoms. Warning signs are trouble or pain swallowing, unexpected weight loss, chest pain or pressure, ongoing heartburn or indigestion, and a chronic cough or hoarseness. These symptoms usually have common, non-cancer causes. But persistent or worsening symptoms—especially trouble swallowing—are worth discussing with a doctor.

What to do with this information

This doesn't mean an occasional hot cup of tea or coffee is dangerous. The authors frame it as a prevention target: let a hot drink cool a few minutes. Or cut back if you regularly have six or more hot drinks daily. It's a low-cost habit that may modestly lower long-term SCC risk. Esophageal cancer's clearer risk factors—smoking, heavy alcohol, chronic acid reflux, and obesity—are far bigger prevention targets than drink temperature.

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How this article was prepared

An AI-assisted editorial system helped prepare this page, drawing on the original peer-reviewed study in the International Journal of Cancer and news coverage from Fox News, CNN, and The BMJ. No named medical reviewer has reviewed it unless one is listed.

Cancer Explained is published by the National Cancer Information Foundation. It is not medical advice and does not suggest a test or treatment.

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